Defaulter Rate

What: The indicator measures what? It represents the proportion of all children discharged from the program who were absent for two consecutive weighings (i.e., so-called “defaulters”). Why: Why is it important to use the indicator? Children who are defaulting are likely not yet recovered and therefore still have a high risk of dying (or whose death was unknown to the project). The indicator can also flag challenges (that warrant follow-up) by the project related to ensuring regular attendance of patients (due to various reasons). The defaulter rate is one of the four core performance indicators of malnutrition (MAM and SAM) treatment programs. When: Which projects should use the indicator? To measure the outcome and quality of CMAM programs (MAM and SAM)

Divide the number of “defaulters” by the total number of discharged children and multiply the result by 100. The resulting number is the default rate (in percentage).

Disaggregate the data by gender, treatment location/ geographic area, age group and (if relevant) specific vulnerable groups, such as children from minority groups. Note, disaggregation by gender is only possible if the CMAM database records cases in this way.

Some programs may like to differentiate between confirmed and unconfirmed defaulters.

1) The indicator does not require a separate survey – all data can be gained from the treatment program’s registration book and may be calculated in the CMAM database file.

2) According to the Sphere Standards, a defaulter rate of less than 15% is perceived as “acceptable”.

3) The four core performance indicators of a malnutrition treatment program (esp. the Community Management of Acute Malnutrition, CMAM), including supplementary feeding programs (SFP) and outpatient therapeutic program (OTP) and inpatient program or stabilization center (IP/ SC)) are recovery rate, death rate, defaulter rate and non-recovery rate. They need to be reported together because they are interlinked (should add up to 100%).

4) A general way to think about defaulter is "the service is available but the child is absent" so the normal reason for default is difficulty to access the health facilities. However, in case a deficiency arises in the treatment program (such as stock out of Ready-to-Use Therapeutic Food) and the child still attends the programme but does not receive treatment, there is a need to capture that deficiency in some way. In case a new discharge category (e.g. unplanned service interruption) is created to capture this, the new category should be included in the denominator for the total number of discharges when calculating program outcomes. See more in discussions at En-Net.